终末期肾脏病患者导管相关性血流感染发生现状及其影响因素研究  

Current Status and Influencing Factors of Catheter-related Bloodstream Infections in End-stage Renal Disease Patients

作　　者：刘杰 Liu Jie(Blood Purification Room,Henan Kaifeng Traditional Chinese Medicine Hospital,Kaifeng,Henan,475000,China)

机构地区：[1]开封市中医院血液净化室,河南开封475000

出　　处：《黑龙江医学》2025年第5期542-544,548,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨终末期肾脏病(ESRD)患者导管相关性血流感染(CRBSI)发生现状及其影响因素。方法:选取2021年4月—2023年7月开封市中医院行血液透析(HD)治疗的88例ESRD患者作为研究对象,调查ESRD患者CRBSI发生现状,并分析CRBSI发生的相关影响因素。结果:86例ESRD患者中24例患者发生CRBSI,62例患者未发生CRBSI。ESRD患者年龄、吸烟史、导管留置时间、置管部位、急性生理与慢性健康Ⅱ(APACHEⅡ)评分、合并糖尿病、白蛋白、甲状旁腺激素(iPTH)、铁蛋白(SF)水平与其CRBSI发生有关,差异均有统计学意义(χ^(2)=4.871、5.523、8.195、7.173、6.345、10.072、7.079、4.527、4.921,P<0.05);多因素logistic回归分析结果显示,ESRD患者年龄≥60岁、有吸烟史、导管留置时间>14 d、股静脉置管、APACHEⅡ>15分、合并糖尿病、白蛋白<35 g/L、iPTH≥235 pg/mL、SF>360μg/L是其发生CRBSI的高危因素(OR=3.339、3.533、4.074、3.706、3.772、4.800、3.703、2.826、2.940,P<0.05)。结论:ESRD患者易发生CRBSI,其发生于年龄、吸烟史、导管留置时间、病情严重程度、置管部位、合并糖尿病和白蛋白、iPTH、SF水平有关。Objective:To explore the current status and influencing factors of catheter-related bloodstream infection(CRBSI)in patients with end-stage renal disease(ESRD).Methods:88 ESRD patients who underwent HD treatment in the hospital from April 2021 to July 2023 were selected.Data on the enrolled subjects were collected through the hospital’s electronic medical record system to investigate the current status of CRBSI in ESRD patients and analyze the relevant influencing factors of CRBSI occurrence.Results:Among 86 ESRD patients,24 patients(27.91%)developed CRBSI,while the remaining 62 patients(72.09%)did not develop CRBSI.Age,smoking history,catheter retention time,catheter placement site,APACHE II score,diabetes mellitus,albumin,parathyroid hormone(iPTH)and ferritin(SF)levels of ESRD patients were correlated with the occurrence of CRBSI.The difference was statistically significant(χ^(2)=4.871,5.523,8.195,7.173,6.345,10.072,7.079,4.527,4.921;P<0.05).The results of multivariate logistic regression analysis showed that ESRD patients with age≥60 years old,history of smoking,catheter retention time>14 days,femoral vein catheterization,APACHEⅡ>15 points,diabetes mellitus,albumin<35 g/L,iPTH≥235 pg/mL,SF>360μg/L were high risk factors for CRBSI.The difference was statistically significant(OR=3.339,3.533,4.074,3.706,3.772,4.800,3.703,2.826,2.940;P<0.05).Conclusion:ESRD patients are prone to CRBSI,which is related with age,smoking history,catheter indwelling time,severity of disease,location of catheter indwelling,and diabetes associated with the levels of albumin,iPTH and SF.

关 键 词：终末期肾脏病 甲状旁腺激素 导管相关性血流感染 铁蛋白 糖尿病 

分 类 号：R699.2[医药卫生—泌尿科学]